Ingredient guide
Horse chestnut seed extract, standardised to escin, is one of the best-studied herbs for chronic venous insufficiency. A Cochrane review of 17 RCTs supports improvements in leg pain, swelling, and itching. Raw seeds and bark are toxic.
Moderate evidenceHorse chestnut is the seed of the Aesculus hippocastanum tree, used for centuries in Europe for leg swelling. The seed contains escin (also spelled aescin), a triterpenic saponin that is the main active compound. Modern products are standardised seed extracts, since the raw plant contains toxic esculin.
A Cochrane review of 17 randomised trials found that horse chestnut seed extract standardised to escin reduced leg pain, swelling (oedema), and itching in people with chronic venous insufficiency. Trials ran 2 to 16 weeks. The mechanism appears to involve inhibiting hyaluronidase, an enzyme that breaks down vein wall proteoglycans. We grade the evidence as moderate.
Trials commonly use horse chestnut seed extract standardised to 50 mg of escin twice daily. Take with food. Use only properly prepared standardised extracts, never raw seeds or bark. Ask your healthcare provider before regular use if you take blood-thinning medicine.
Yes. A Cochrane review supports improvements in leg pain, swelling, and itching with standardised seed extract.
Standardised seed extract is generally well tolerated. Raw seeds, leaves, and bark are toxic, so use only commercial extracts.
